MEDICARE: MANISHA SINGHI GARG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301072790	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740288984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANISHA SINGHI GARG MD

Provider Business Mailing Address
First Line	:	26850 PROVIDENCE PKWY
Second Line	:	PMOB 200
City	:	NOVI
State	:	MI
Zip	:	48374-1213
Country	:	US
Telephone Number	:	248-465-3144
Fax Number	:	248-465-3146

Provider Business Practice Location Address
First Line	:	23874 KEAN ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-1804
Country	:	US
Telephone Number	:	313-359-0801
Fax Number	:	313-359-2674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	06/11/2013

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